The objectives of this review are to highlight the impact of the first decade of high-risk (HR) infant sibling work in autism spectrum disorder (ASD) and to identify potential areas of translational ...focus for the next decade of research.
A group of clinicians and researchers in ASD working both inside and outside of the HR design met on a regular basis to review the infant sibling research, and came to an agreement on areas that had changed clinical practice and areas that had the potential to change practice with further research. The group then outlined several methodological and translational challenges that must be addressed in the next decade of research if the field is to reach its potential.
The review concluded that the HR design has yielded an understanding that ASD often, but not always, begins to emerge between 6 and 18 months, with early signs affecting social communication. Research using the HR design has also allowed a better understanding of the sibling recurrence risk (between 10% and 20%). Emerging areas of interest include the developmental trajectories of social communications skills in the early years, the expression of a milder phenotype in siblings not affected with ASD, and the possibility that early intervention with infant siblings may improve outcomes for those with ASD. Important challenges for the future include linking screening to intervention, collecting large sample sizes while ensuring cross-site reliability, and building in capacity for replication.
Although there are significant methodological and translational challenges for high-risk infant sibling research, the potential of this design to improve long-term outcomes of all children with ASD is substantial.
Sibling bullying is highly prevalent and has been found to have adverse effects on mental health lasting into early adulthood. What is unknown is what predicts sibling bullying roles (uninvolved, ...victim, bully-victim and bully). This study aimed to identify precursors of sibling bullying roles in middle childhood using a large sample of 6,838 children from the Avon Longitudinal Study of Parents and Children, a prospective United Kingdom birth-cohort. The relative associations of four sets of precursors: (a) structural family characteristics, (b) parent and parenting characteristics, (c) early social experiences, and (d) child individual differences was assessed before 8 years of age. Structural family characteristics (being the firstborn and having older brothers) and sex (being male) were the strongest predictors of sibling bullying, consistent with an evolutionary model of sibling aggression. Parenting variables, early social experiences, and child individual differences made significant but smaller contributions. These findings may help to identify at-risk families, allowing for appropriate interventions to be implemented from birth.
The present study is the first to examine patterns in sibling relationship quality and the associations of these patterns with internalizing and externalizing problem behavior, as well as ...self-perceived competence, in middle childhood. Self-report questionnaires (e.g., Sibling Relationship Questionnaire, Self-Perception Profile for Children, Youth Self Report) were administered among 1,670 Dutch children (Mage = 11.40 years, SD = .83) attending 51 different Dutch schools. Three sibling relationship clusters were found: a conflictual cluster (low on warmth, high on conflict), an affect-intense cluster (above average on warmth and conflict), and a harmonious cluster (high on warmth, low on conflict). Sister pairs were underrepresented in the conflictual cluster and overrepresented in the harmonious cluster. Children with conflictual sibling relationships reported significantly more internalizing and externalizing problems, and lower academic and social competence and global self-worth, than children with harmonious sibling relationships. Children with affect-intense sibling relationships reported less aggression and better social competence than children with conflictual sibling relationships. Our findings indicate that it is fruitful to combine indices of sibling warmth and conflict to examine sibling relationship types. Relationship types differed significantly concerning internalizing and externalizing problems, but also concerning self-perceived competence. These findings extend our knowledge about sibling relationship types and their impact on different aspects of child adjustment. Whereas harmonious sibling relationships are the most beneficial for adjustment, sibling conflict mainly has a negative effect on adjustment in combination with lack of sibling warmth. Implications and future directions are discussed.
Background
There are few published research studies in which siblings of children with autism spectrum disorder (ASD) provide self‐reports about their own behavioural and emotional problems and their ...sibling relationships. Reliance on parent reports may lead to incomplete conclusions about the experiences of siblings themselves.
Methods
Siblings 7–17 years and their mothers from 94 families of children with ASD were recruited. Mothers reported on family demographics, the behavioural and emotional problems of their child with ASD, and on their own symptoms of depression. Siblings reported on their relationship with their brother or sister with ASD, and siblings 11+ years of age also self‐reported on their behavioural and emotional problems.
Results
Compared with normative British data, siblings reported very slightly elevated levels of behavioural and emotional problems. However, none of the mean differences were statistically significant and all group differences were associated with small or very small effect sizes – the largest being for peer problems (effect size = 0.31). Regression analysis was used to explore family systems relationships, with sibling self‐reports predicted by the behaviour problems scores for the child with ASD and by maternal depression. Maternal depression did not emerge as a predictor of siblings' self‐reported sibling relationships or their behavioural and emotional problems. Higher levels of behaviour problems in the child with ASD predicted decreased warmth/closeness and increased conflict in the sibling relationship.
Conclusions
These data support the general findings of recent research in that there was little indication of clinically meaningful elevations in behavioural and emotional problems in siblings of children with ASD. Although further research replication is required, there was some indication that sibling relationships may be at risk where the child with ASD has significant behaviour problems.
Objectives
Siblings' psychosocial adjustment to childhood cancer is poorly understood. This systematic review summarizes findings and limitations of the sibling literature since 2008, provides ...clinical recommendations, and offers future research directions.
Method
MEDLINE/Pubmed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO were searched for articles related to siblings, psychosocial functioning, and pediatric cancer. After systematic screening, studies meeting inclusion criteria were rated for scientific merit, and findings were extracted and synthesized. In total, 102 studies were included (63 quantitative, 35 qualitative, 4 mixed‐methods).
Results
Methodological limitations are common. Mean levels of anxiety, depression, and general adjustment are similar across siblings and comparisons, but symptoms of cancer‐related posttraumatic stress are prevalent. School‐aged siblings display poorer academic functioning and more absenteeism but similar peer relationships as peers. Quality of life findings are mixed. Adult siblings engage in higher levels of risky health behaviors and may have poorer health outcomes than comparisons. Risk factors for poor sibling adjustment include lower social support, poorer family functioning, lower income, non‐White race, and shorter time since diagnosis, but findings are inconsistent. Qualitative themes include siblings' maturity, compassion, and autonomy, but also strong negative emotions, uncertainty, family disruptions, limited parental support, school problems, altered friendships, and unmet needs.
Conclusion
Despite methodological limitations, research indicates a strong need for sibling support. Clinical recommendations include identifying at‐risk siblings and developing interventions to facilitate family communication and increase siblings' social support, cancer‐related knowledge, and treatment involvement. Future longitudinal studies focusing on mechanisms and moderators of siblings' adjustment would inform timing and targets of psychosocial care.
Sibling bullying is associated with various psychosocial difficulties. We investigated this in 231 individuals with Autism Spectrum Disorder (ASD) and 8180 without ASD between middle childhood (age ...11 years) and early adolescence (age 14 years). On the whole, self-reported sibling bullying decreased from middle childhood to early adolescence. Despite this, individuals with ASD continued to report more sibling bullying as both perpetrator and victim in early adolescence than those without ASD. We found that self-report sibling bullying in middle childhood was associated with psychosocial difficulties in early adolescence. Moreover, individuals with ASD were more likely to report being bullied by both siblings and peers in middle childhood and this pattern of victimisation was associated with concurrent and longitudinal psychosocial difficulties.
Using data from a prospective population based study, the prevalence and psychopathological correlates of sibling bullying in children with and without autism spectrum disorder (ASD) were estimated. ...There were 475 children with ASD and 13,702 children without ASD aged 11 years. Children with ASD were more likely to be bullied by their siblings compared to those without ASD. They were also more likely than those without ASD to both bully and be bullied by their siblings, which was associated with lower prosocial skills as well as more internalizing and externalizing problems compared to those not involved in any sibling bullying. Interventions to improve social and emotional outcomes in children with ASD should focus on both the affected and the unaffected sibling.
This study examined the unique relations between multiple sources (i.e., mothers, teachers, and siblings) of perceived daily autonomy support and psychological control and children's basic ...psychological needs and well-being. During 5 consecutive days, 2 children from 154 families (Mage youngest child = 8.54 years; SD = .89 and Mage oldest child = 10.38 years; SD = .87) provided daily ratings of the study variables. Multilevel analyses showed that each of the sources of perceived autonomy support and psychological control related uniquely to changes in daily well-being and ill-being. These associations were mediated by experienced psychological need satisfaction and frustration, respectively. Overall, the findings testify to the dynamic role of autonomy support and psychological control in children's development. Implications for future research are discussed.
Background
This study explored psychological adjustment and sibling relationships of siblings of children with life‐limiting conditions (LLCs), expanding on previous research by defining LLCs using a ...systematic classification of these conditions.
Methods
Thirty‐nine siblings participated, aged 3–16 years. Parents completed measures of siblings' emotional and behavioural difficulties, quality of life, sibling relationships and impact on families and siblings. Sibling and family adjustment and relationships were compared with population norms, where available, and to a matched comparison group of siblings of children with autistic spectrum disorder (ASD), as a comparable ‘high risk’ group.
Results
LLC siblings presented significantly higher levels of emotional and behavioural difficulties, and lower quality of life than population norms. Their difficulties were at levels comparable to siblings of children with ASD. A wider impact on the family was confirmed. Family socio‐economic position, time since diagnosis, employment and accessing hospice care were factors associated with better psychological adjustment.
Conclusions
Using a systematic classification of LLCs, the study supported earlier findings of increased levels of psychological difficulties in siblings of children with a LLC. The evidence is (i) highlighting the need to provide support to these siblings and their families, and (ii) that intervention approaches could be drawn from the ASD field.
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